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Ferric carboxymaltose for anemia in Crohn’s disease patients at a tertiary center:A retrospective observational cohort study

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World Journal of Clinical Cases 2023年第12期11卷 2740-2752页

作者： Natália Souza Nunes Siqueira Livia Bitencourt Pascoal Bruno Lima Rodrigues Marina Moreira de Castro Alan Sidnei Corrêa Martins Dante Orsetti Silva Araújo Luis Eduardo Miani Gomes Michel Gardere Camargo maria de lourdes Setsuko Ayrizono Raquel Franco Leal Inflammatory Bowel Disease Research Laboratory GastrocenterColorectal Surgery UnitSchool of Medical SciencesUniversity of Campinas(Unicamp)Campinas 13083-878São PauloBrazil

BACKGROUND Although the gastrointestinal tract is the most affected by Crohn’s disease(CD),the condition triggers other consequent manifestations,and iron deficiency anemia(IDA)is one of the most ***(IV)iron replacement is currently available through several drugs,such as ferric hydroxide sucrose and ferric carboxymaltose(FCM).However,the clinical management of these conditions can be *** To elucidate the drug’s effectiveness,the present study analyzed,through medical records,the clinical and epidemiological data of a cohort of patients with active CD who received IV FCM for the IDA *** This retrospective observational study included 25 patients with active CD,severe anemia,and refractory to previous conventional *** were evaluated two times:During the last treatment with ferric hydroxide sucrose and treatment with *** After treatment with FCM,parameters of IDA assessment significantly improved,serum hemoglobin(Hb)levels increased in 93%of patients(P<0.0001),and in 44%,there was an increase of≥2 g/dL in a single *** addition,86%of the patients showed an increase in serum iron(P<0.0001)and ferritin(P=0.0008)and 50%in transferrin saturation(P=0.01).The serum iron levels at baseline showed a negative association with the ileal and colonic CD and use of biologics and a positive association with patients who developed CD later in life after the age of 40(A3)and with a stenosing(B2)and fistulizing(B3)*** values of Hb and hematocrit after ferric hydroxide sucrose treatment remained similar to those found before *** This study demonstrated that FCM is an important therapeutic strategy for treating IDA in CD patients,achieving satisfactory results in refractory cases.

关键词： Ferric carboxymaltose Iron deficiency anemia Crohn’s disease Inflammatory bowel disease Anemia Clinical management

Symptomatic changes in postmenopause with different methods of hormonal therapy

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Open Journal of Preventive Medicine 2011年第2期1卷 20-24页

作者： Marcelino Hernández-Valencia Nydia Cordova Antonio Vargas lourdes Basurto Renata Saucedo Carlos Vargas Miriam ruiz Leticia Manuel-Apolinar Arturo Zárate 不详

Objective: The diversity of opinions on the adverse effects of medications used to treat postmenopausal symptoms has prompted the use of various routes and mechanisms of action that need to be explored because bioavailability of the medications can vary. In order to select the appropriate route of administration for hormonal therapy (HT), it is necessary to determine baseline therapeutic efficacy. Design: We designed a prospective, randomized study consisting of four groups of postmenopausal wo-men: group 1 received oral conjugated estrogens, group 2 received a synthethic steroid, group 3 received estradiol nasally in spray form, and group 4 used transdermal estradiol in the form of patches. Criteria used to evaluate effectiveness was the Greene scale, which evaluate six components. These criteria were applied to each patient before hormonal intervention and then each month for 6 months. Luteinizing hormone (LH), follicle stimulating horone (FSH) and estradiol concentration were determined by chemiluminescence. Student’s t-test was used for intra-group comparisons before and after treatment. Results: There was a significant decrease in the vasomotor and sexual component (p < 0.05) with the use of four HT types. For depression, a difference was observed with synthetic steroids and oral estrogens. Upon analyzing the somatic component there was a decrease in symptoms with nasal and transdermal routes. Psychological changes were observed with the use of oral synthethic steroids and transdermal patches. Anxiety component demonstrated differences with nasal spray and oral estrogens, although all HT forms in this component showed a pattern of irregular changes. Conclusions: Changes in the response could be due each route of administration and medication used. Absorption variability may exist, which has repercussions in the control of symptoms and should be taken into consideration when selecting the appropriate route of administration for patients beginning HT.

关键词： hormonal therapy transdermal estradiol tibolone oral estrogen nasal estradiol postmenopause

Review: Surgical Treatment of Type 2 Diabetes

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Pharmacology & Pharmacy 2014年第1期5卷 24-29页

作者： maria Dolores Hellin Gil Pedro Pujante Alarcon Alfonso Lopez ruiz maria Angeles Ibanez Alicia Hernandez Torres Ana Belen Hernandez Cascales Nutrition Service Hospital University Virgen de la Arrixaca de MurciaMurciaSpain Endocrinology and Nutrition Service Hos-pital University Virgen de la Arrixaca de MurciaMurciaSpain Community Pharmacy Bullas(Murcia)Spain Health Center Mar-iano Yago Yecla(Murcia)Spain Infectious Internal Medicine Hospital University Virgen de la Arrixaca de MurciaMurciaSpain

In the last decades we have witnessed a significant increase in the incidence of type 2 diabetes mellitus, and obesity in parallel. So 90% of patients with Diabetes Mellitus type 2 (DM2) are obese. Changes in lifestyle (diet and exercise), behavioral therapies or the use of certain anti-obesity drugs have shown a limited effect and are not maintained over time. Currently, bariatric surgery is the most effective anti-obesity treatment, which is durable and resolves associated comorbidities. The surgical treatment of obesity for the modification of the anatomy of the digestive system is to produce gastric capacity constraints alone or associate with varying degrees of intestinal malabsorption and reduce body weight, improve and maintain the comorbidities associated weight loss by reduced food intake alone or in combination with malabsorption of this. The development of these surgical techniques has occurred in stages. With these techniques, setting to bariatric surgery is an effective, safe and proven procedure for the treatment of obesity and its complications especially DM2, as their post surgery referral mechanisms provide us with information for potential therapeutic treatment aimed at optimizing the control DM2 patients metabolic obese. In this review, we expose the evidence in treatment of DM2 with bariatric surgery and the actual hypothesis trying to explain how it is possible.

关键词： DM2 Bariatric Surgery Gastric Bypass

Involvement of TLR2 and TLR4,Chlamydophila pneumoniae and Mycoplasma pneumoniae in adventitial inflammation of aortic atherosclerotic aneurysm

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World Journal of Cardiovascular Diseases 2014年第1期4卷 14-22页

作者： Renata Melo de Assis maria de lourdes Higuchi Marcia Martins Reis Suely APPalomino Rosario Dominguez Crespo Hirata Mario Hiroyuki Hirata Faculty of Pharmaceutical Sciences University of Sao PauloSao PauloSPBrazil Heart Institute of Clinical Hospital Medical SchoolUniversity of Sao PauloSao PauloSPBrazil

Aortic atherosclerotic aneurysm (AAA) is associated with adventitial inflammation where infection is suggested to have a role. Co-infection with Chlamydophila pneumoniae (Cp) and Mycoplasma pneumoniae (Mp) was linked with coronary plaque rupture, in association with vessel dilatation and adventitial inflammation. Pathogens are recognized by Toll-like receptors (TLRs) development of the inflammatory process. Objective: Here, we studied whether co-infection by Cp and Mp was involved in the increased inflammation present in AAA and if it could be associated with deficient expression of TLRs. We compared human samples of AAA with non-dilated human aortic atherosclerotic lesions, regarding the amount of Cp and Mp antigens, and expression of TLR2 and TLR4. Methods: Two groups of aorta fragments were analyzed: G1 (n = 13) moderate atherosclerosis and G2 (n = 14) AAA samples, through immunohisto-chemistry and in situ hybridization methods. Results: Mp and Cp antigens in intima/medial layer were greater in G2 than G1, with no difference in adventitia. TLR2 and TLR4 were higher in G2 than G1 adventitia fat. There was a correlation between Mp versus TLR2 and of TLR4 in intima/medial layer and in adventitia of G1, but there was a lack of correlation in G2. In Cp adventitia, the correlation in G1 was high with TLR2 but not with TLR4, and in G2 the correlation was positive for both TLRs. Conclusion: This study favors the concept that symbiotic co-infection by Cp and Mp participates in the pathogenesis of AAA. It also emphasizes that adventitial fat is the initial site for colonization of these bacteria that probably reach the tissue through vasa vasorum. An exacerbated immune reaction is not efficient to control the infection that reaches and proliferates in high levels at the medial and intimal layer, contributing to the development of vessel dilatation.

关键词： Aortic Atherosclerotic Aneurysm Inflammation Co-Infection Chlamydophila pneumoniae Mycoplasma pneumoniae Toll-Like Receptors

Safety and Efficacy of PTCTS Cosmetic Gel: Study on Human Radiodermatitis Lesions

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Case Reports in Clinical Medicine 2015年第10期4卷 327-333页

作者： Silvia Regina Graziani Brigitte M. Van Eyll Carlos Elias Fristachi maria de lourdes Higuchi Renata Ikegami Jose Antonio Ramires Arnaldo Vieira de Carvalho Cancer Institute Sao Paulo Brazil Heart Institute (InCor) of Clinical Hospital Medical School University of S&atildeo Paulo S&atildeo Paulo Brazil

Radiodermatitis is a constant complication after radiotherapy with no efficient drug for prevention and treatment. Its physiopathology is complex, possibly related to injury of epidermis and endothelial cells from the basal layer by radiolysis, overproduction of free radicals, pro-inflammatory cytokines, and inflammation. PTCTS gel is an after sun cosmetic gel composed by anti-oxidative plant extract rich in natural nanoparticles and thermal water (Complex A) and recombinant protein of Trypanosoma cruzi transialidase (Complex B), with high anti-oxidative and anti-apoptotic effects, presenting anti-aging and healing cutaneous properties. Objective: To study the safety and efficacy of PTCTS gel for topic use in volunteer subjects with healthy skin, and in patients with radiodermatitis, in different concentrations of Complexes A and B. Material and Methods: The project was approved by the Ethical Committee of Arnaldo Vieira de Carvalho Institute, Sao Paulo, Brazil. The individuals were submitted to laboratorial toxicity study through tests for liver and kidney function, levels of blood glucose and blood count before and after 7 days of PTCTS application. We studied two groups: GI-22 volunteers with healthy skin, presenting articular or skeletal muscle pain and GII-38 patients in radiotherapy for breast or head and neck cancer, with radiodermatitis grade 2 or 3. The patients were evaluated before and after 1.0 ml/cm2 PTCTS gel application, twice a day. We tested Complex B in four different concentrations, and Complex A concentrations varied inversely. Results: No irritation signs were observed in GI nor GII group, 64% of GI had important decrease in the intensity of the muscular or articular pain, and 99% of GII showed regression of radiodermatitis, all exhibiting relief of pain. No patient presented hematologic, renal or hepatic toxicity. Conclusion: PTCTS cosmetic gel is a safe option for radiodermatitis treatment, with no side effects or laboratorial toxicity in diff

关键词： Radiodermatitis Nanoparticles Thermal Water Transialidase Toxicity PTCTS Cosmetic Gel

Sleep Quality in Non Dialysis Chronic Kidney Disease: Associated Factors and Influence on Prognosis

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International Journal of Clinical Medicine 2016年第7期7卷 481-486页

作者： Jesús Calviño lourdes Gonzalez-Tabarés Secundino Cigarrán Beatriz Millán Monica Guijarro Carmen Cobelo maria-Jesús Sobrido Department of Nephrology Hospital Lucus Augusti EOXI Lugo-Cervo-Monforte Lugo Spain Department of Nephrology Hospital da Costa EOXI Lugo-Cervo-Monforte Burela Lugo Spain Department of Neurology Hospital Lucus Augusti EOXI Lugo-Cervo-Monforte Lugo Spain Department of Neurology Fundación Pública Galega de Medicina Xenómica-SERGAS Instituto de Investigación Sanitaria Santiago de Compostela Spain Department of Neurology Hospital San Rafael A Coru&ntildea Spain

Deficient sleep quality (SQ) has been linked with a higher hospitalization rate and mortality in dialysis patients, however the prevalence of sleep disorders and their influence on prognosis in non-dialysis chronic kidney disease (CKD) has been poorly investigated. The aim of this study was to assess factors related with SQ in CKD patients (stages I-IV) followed in a nephrology outpatient clinic as well as the long-term impact of SQ on patient’s outcome. Between January and May 2008, Pittsburgh Sleep Quality Index (PSQI) was self-administered by 122 patients (68 males and 54 females) with a mean age of 65 years. Patients were classified as “good” (global PSQI < 6) and “poor” sleepers (global PSQI ≥ 6). We identified 66 (54%) poor sleepers (PS), characterized by an older age (66 ± 14.2 vs 57 ± 17.0, p < 0.01), female predominance (59% vs 26%, p < 0.01) and worse renal function (49 ± 19.1 vs 57 ± 23.2 ml/min, p < 0.05). There was a significant correlation between phosphate and PSQI score (r = 0.234, p = 0.01), however no correlation with calcium or PTH. Vitamin D was also lower in PS (17 ± 7.2 vs 23 ± 15.1 ng/ml, p < 0.05). Until June 2015, hospitalization rate was higher among PS (64% vs 44%, p < 0.05). In this period, there was also a trend towards higher mortality for PS (18% vs 16%). In summary, over 50% of CKD patients have poor SQ, which was associated with older age, female gender, worse renal function, lower vitamin D and higher phosphate levels. Deficient sleep was associated with a greater probability of hospitalization and might be a prognostic marker in CKD.

关键词： Chronic Kidney Disease Sleep Quality Hospitalization Pittsburgh Sleep Quality Index Vitamin D

Morbid Obesity in Diabetes Mellitus Type 2 and Exenatide

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Pharmacology & Pharmacy 2014年第2期5卷 149-152页

作者： maria Angeles Ibanez Gil Alfonso Lopez ruiz Alicia Hernandez Torres Ana Belen Hernandez Cascales Pedro Pujante Alarcon maria Dolores Hellin Gil Health Center mariano Yago YeclaSpain Pharmaceutical Care Research at the University of Granada GranadaSpain Infectious Internal Medicine of the Hospital University Virgen de la Arrixaca MurciaSpain Endocrinology and Nutrition Service of the Hospital University Virgen de la Arrixaca MurciaSpain

Worldwide, the prevalence of diabetes and obesity is increasing in recent years in developed countries. The first step of treatment is changes in lifestyle and in case of failure to initiate drug treatment. In our case, the patient with morbid obesity and glucose intolerance to metformin therapy was initiated without achieving weight loss and loss of glycemic control after 6 months of treatment. It was decided to add exenatide as an alternative to bariatric surgery. At the end of the study (12 months), it showed a weight reduction of 20.8% (Table 1), 20.83% BMI, glycosylated hemoglobin decrease of 2 points, and improved the lipid profile. So exenatide may be an acceptable option in the use of patient profile. It would be necessary to seek a new alternative treatment with minimal side effects and less healthcare costs.

关键词： Type 2 Diabetes and Obesity Exenatide

Statins and Sepsis Literature Review

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Pharmacology & Pharmacy 2013年第8期4卷 573-577页

作者： Alicia Hernandez Torres Ana Belen Hernandez Cascales Pedro Pujante Alarcon Alfonso Lopez ruiz mariaÁngeles Ibanez Gil maria Dolores Hellin Gil Hospital University Virgen de la Arrixaca de Murcia MurciaSpain Hospital University Virgen de la Arrixaca de Murcia MurciaSpain Pharmaceutical Care Research at the University of Granada GranadaSpain Health Center mariano Yago MurciaSpain

Recent data suggest that, in addition to improving dyslipidemia, statin may reduce the risk of infections and infection-related complications. The aim of this study is to make a review of the literature about the effects of statins on clinically relevant outcomes of patients admitted to the hospital and having an infection and/or sepsis, principally in terms of intensive care unit admissions and related death.

关键词： Statins Pravastatin Simvastatin Sepsis Bacteremia Mortality

Evolution of Biochemical Effects of Byetta<sup>®</sup>in Type 2 Diabetics with Cardiovascular Risk

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Pharmacology & Pharmacy 2013年第9期4卷 679-683页

作者： Alfonso Lopez ruiz maria Angeles Ibanez Gil Pedro Pujante Alarcon Alicia Hernandez Torres Ana Belen Hernandez Cascales maria Dolores Hellin Gil Pharmaceutical Care Research at the University of Granada GranadaSpain Health Center mariano Yago YeclaMurciaSpain Endocrinology and Nutrition Service of the Hospital University Virgen de la Arrixaca MurciaSpain Infectious Internal Medicine of the Hospital University Virgen de la Arrixaca MurciaSpain.

The objective of this study was to examine longitudinally the effects of exenatide on different physical and biochemical markers, evaluated in adult type 2 diabetic patients with cardiovascular risk. Data were recorded from 10 patients who attended the outpatient primary care health center mariano Iago Yecla, Murcia province, Spain in the period of December 2009 to October 2011 and who were treated with Byetta®. Differences were statistically significant (p 0.05) in HbA1c from the third month of treatment, and trends of decrease in body weight from the third week of treatment. There was a significant and better glycemic control. Overall effect was interpreted as a sensitizer drug of the parameters evaluated. Randomized studies are recommended with a minimum follow-up of 2 years, to see if the results are maintained over time.

关键词： Diabetes Mellitus Type 2 Exenatide Cardiovascular Risk